OP0195 PREVALENCE OF SURVEY-BASED CRITERIA FOR FIBROMYALGIA AND IMPACT ON HOSPITAL BURDEN: A 7 YEARS FOLLOW UP STUDY FROM AN OUTPATIENT CLINIC
Authors: P. Lage-Hansen, S. Chrysidis, K. Amris, S. Fredslund-Andersen, R. Christensen, T. Ellingsen
Journal: Annals of the Rheumatic Diseases (2022)

Background The prevalence of Fibromyalgia (FM) among newly referred patients to rheumatic outpatient clinics is unknown. It is well described that FM patients have increased use of the secondary healthcare facilities, however to what extent the presence of FM burdens the different medical specialties in the secondary health care sector is still unknown. Objectives To evaluate the prevalence of fulfilment of survey-based criteria for FM (1) among newly referred patients in a rheumatic outpatient clinic and to compare the use of secondary health care services between survey-based FM- and non-FM cases. Methods This is an observational cohort study. Newly referred patients with the suspicion of rheumatic inflammatory disease in an outpatient clinic were evaluated for fulfilment of 2011 FM survey criteria during a 6-month period in 2013. Demographic data were obtained at baseline. Seven years later, patients’ medical files were evaluated, and comparisons between groups were made regarding the use of hospital healthcare facilities during the observation period. Results were adjusted for sex, age, and multiplicity. Results 248 patients of 300 invited (83%) completed the questionnaire; 90 patients (36%) fulfilled FM criteria at enrolment (Figure 1). FM cases were primarily women (80% vs. 54%) and received more public economical support (62% vs. 20%). At 7 years follow up, adjusted results shows that FM cases had higher number of hospital courses (13 vs. 9) and had undergone more invasive procedures (78% vs. 60%), however differences concerning number of diagnoses between groups were small. Neurologists (42% vs. 28%), gastroenterologists (30% vs. 13%), endocrinologists (40% vs. 21%), pain-specialists (13% vs 3%), psychiatrists (20% vs. 7%), and abdominal surgeons (43% vs. 30%) were consulted more often by FM cases than non-FM cases. Conclusion Fulfilment of FM survey criteria among newly referred patients with the suspicion of a rheumatic inflammatory disease to a rheumatic outpatient clinic is frequent. The burden to the secondary healthcare system in these patients is significant. The finding of a minimal difference between groups regarding the number of resulting diagnoses underlines that prolonged and excessive use of healthcare services with referral to multiple specialists should be avoided. Our study findings also support that FM continues to present a challenge for healthcare professionals as well as for patients. A timely and coordinated effort across medical specialties, including rheumatologists, could reduce diagnostic delay, facilitate management, and reduce healthcare utilisation in this patient population. References [1]Ferrari, R. and A.S. Russell, A Questionnaire Using the Modified 2010 American College of Rheumatology Criteria for Fibromyalgia: Specificity and Sensitivity in Clinical Practice. Journal of Rheumatology, 2013. 40 (9): p. 1590-1595. Table 1. Highlighting primary baseline data, primary and secondary endpoints, main differences regarding invasive procedures and medical specialists consulted during seven years follow up. Fibromyalgia, n= 86 Non-fibromyalgia, n=151 P -value* Age (years), mean (SD ) 52.5 (13.7 ) 52.8 (18.6 ) 0.432 Female, % 80 54 &lt; 0.001 Social economic support of any kind, % 62 20 &lt; 0.001 Rheumatic inflammatory disease, % 28 42 0.028 Number of different courses at hospital, Mean (SD ) 12.7 (0.9 ) 9 (0.6 ) &lt; 0.001 Number of diagnoses, Mean (SD ) 5 (0.3 ) 4 (0.2 ) 0.003 Numbers of admissions to hospital, Mean (SD ) 2.1 (0.3 ) 1.9 (0.2 ) 0.550 Number of Medications, Mean (SD ) 7.1 (0.5 ) 6.1 (0.3 ) 0.057 Number of Pain Medications, Mean (SD ) 1.6 (0.1 ) 1.2 (0.1 ) 0.004 Invasive procedures total, % 78 60 0.003 Joint surgery other (including arthroscopies), % 30 17 0.026 Gastroscopy, % 37 14 &lt; 0.001 Colonoscopy, % 38 21 0.004 Psychiatry, % 20 7 0.006 Abdominal Surgery, % 43 30 0.042 Pain centre, % 13 3 0.015 Endocrinology, % 40 21 0.003 Gastroenterology, % 30 13 0.003 Neurology, % 42 28 0.029 Acknowledgements Study data were collected using REDCap (Research Electronic Data Capture) electronic data capture tools hosted at OPEN (Open Patient Data Explorative Network), Odense University Hospital, Region of Southern Denmark Disclosure of Interests None declared